{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T20:46:42Z","timestamp":1761598002502,"version":"3.44.0"},"reference-count":13,"publisher":"The Pediatric Pharmacy Association","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018]]},"abstract":"<jats:p>Vincristine is a chemotherapeutic agent with a potential toxicity of sensorimotor peripheral neuropathy. Patients receiving chemotherapy are in an immunocompromised state and may require antifungal agents. Triazole antifungals are known inhibitors of cytochrome P450 (CYP) enzymes. Vincristine is a known CYP3A4 and CYP3A5 substrate, and concomitant administration with fluconazole or voriconazole has been reported to increase vincristine toxicity and peripheral neuropathy, but there is limited literature on posaconazole in this regard. This 5-year-old girl with pre\u2013B-cell acute lymphoblastic leukemia received vincristine while receiving posaconazole for a mucormycosis infection and developed unexpectedly severe peripheral neuropathy. After recovery, the child continued on mucormycosis prophylaxis with posaconazole with instructions to hold for 2 days before and on the day of vincristine administration. This case illustrates the potentiating effect that posaconazole had on vincristine-associated neurotoxicity, and our approach to mitigating that negative interaction.<\/jats:p>","DOI":"10.5863\/1551-6776-23.5.417","type":"journal-article","created":{"date-parts":[[2018,11,1]],"date-time":"2018-11-01T19:42:41Z","timestamp":1541101361000},"page":"417-420","source":"Crossref","is-referenced-by-count":7,"title":["Severe Neuropathic Pain With Concomitant Administration of Vincristine and Posaconazole"],"prefix":"10.5863","volume":"23","author":[{"given":"Mark John-Yung","family":"Lin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan Rose","family":"Paul","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dennis John","family":"Kuo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3883","reference":[{"issue":"6","key":"i1551-6776-23-5-417-b1","series-title":"Pharmacotherapy","first-page":"1304","article-title":"Pharmacokinetic drug interactions of vinca alkaloids: summary of case reports","volume":"18","year":"1998","unstructured":"Chan\n              JD.\n            \n          \n          Pharmacokinetic drug interactions of vinca alkaloids: summary of case reports. Pharmacotherapy. 1998;18(6):1304\u20131307."},{"issue":"5","key":"i1551-6776-23-5-417-b2","series-title":"Eur J Pharm Sci","first-page":"645","article-title":"Effect of posaconazole on cytochrome P450 enzymes: a randomized, open-label, two-way crossover study","volume":"21","year":"2004","unstructured":"Wexler\n              D\n            , CourtneyR, RichardsW, \n          et al. Effect of posaconazole on cytochrome P450 enzymes: a randomized, open-label, two-way crossover study. Eur J Pharm Sci. 2004;21(5):645\u2013653."},{"issue":"1","key":"i1551-6776-23-5-417-b3","series-title":"Pediatr Hematol Oncol","first-page":"62","article-title":"Potentiation of vincristine toxicity with concomitant fluconazole prophylaxis in children with acute lymphoblastic leukemia","volume":"29","year":"2012","unstructured":"Teusink\n              AC\n            , RagucciD, ShatatIF, \n          et al. Potentiation of vincristine toxicity with concomitant fluconazole prophylaxis in children with acute lymphoblastic leukemia. Pediatr Hematol Oncol. 2012;29(1):62\u201367."},{"key":"i1551-6776-23-5-417-b4","series-title":"Med Sci Monit","first-page":"1656","article-title":"Clinical analysis of adverse drug reactions between vincristine and triazoles in children with acute lymphoblastic leukemia","volume":"21","year":"2015","unstructured":"Yang\n              L\n            , YuL, ChenX, \n          et al. Clinical analysis of adverse drug reactions between vincristine and triazoles in children with acute lymphoblastic leukemia. Med Sci Monit. 2015;21:1656\u20131661."},{"issue":"12","key":"i1551-6776-23-5-417-b5","series-title":"Pediatr Blood Cancer","article-title":"Vincristine toxicity with co-administration of fluconazole: long-term concerns","volume":"64","year":"2017","unstructured":"Thackray\n              J\n            , SpatzK, SteinherzPG.\n          Vincristine toxicity with co-administration of fluconazole: long-term concerns. Pediatr Blood Cancer. 2017;64(12)."},{"key":"i1551-6776-23-5-417-b6","series-title":"Case Rep Hematol","first-page":"343742","article-title":"Posaconazole-vincristine coadministration triggers seizure in a young female adult: a case report","volume":"2012","year":"2012","unstructured":"Hamdy\n              DA\n            , El-GeedH, El-SalemS, \n          et al. Posaconazole-vincristine coadministration triggers seizure in a young female adult: a case report. Case Rep Hematol. 2012;2012:343742."},{"issue":"4","key":"i1551-6776-23-5-417-b7","series-title":"J Pediatr Hematol Oncol","first-page":"292","article-title":"Posaconazole-increased vincristine neurotoxicity in a child: a case report","volume":"31","year":"2009","unstructured":"Eiden\n              C\n            , PalenzuelaG, Hillaire-BuysD, \n          et al. Posaconazole-increased vincristine neurotoxicity in a child: a case report. J Pediatr Hematol Oncol. 2009;31(4):292\u2013295."},{"issue":"11","key":"i1551-6776-23-5-417-b8","series-title":"Am J Cancer Res","first-page":"2416","article-title":"Vincristine-induced peripheral neuropathy in pediatric cancer patients","volume":"6","year":"2016","unstructured":"Mora\n              E\n            , SmithEML, DonohoeC, \n          et al. Vincristine-induced peripheral neuropathy in pediatric cancer patients. Am J Cancer Res. 2016;6(11):2416\u20132430."},{"issue":"2","key":"i1551-6776-23-5-417-b9","series-title":"J Clin Pharm Ther","first-page":"265","article-title":"Severe neurological disorders and refractory aspergillosis in an adolescent treated by vincristine and voriconazole","volume":"43","year":"2017","unstructured":"Bennis\n              Y\n            , BodeauS, LutunA, \n          et al. Severe neurological disorders and refractory aspergillosis in an adolescent treated by vincristine and voriconazole. J Clin Pharm Ther. 2017;43(2):265\u2013268."},{"issue":"2","key":"i1551-6776-23-5-417-b10","series-title":"Pediatr Blood Cancer","first-page":"298","article-title":"Vincristine induced peripheral neuropathy potentiated by voriconazole in a patient with previously undiagnosed CMT1X","volume":"52","year":"2009","unstructured":"Porter\n              CC\n            , CarverAE, AlbanoEA.\n          Vincristine induced peripheral neuropathy potentiated by voriconazole in a patient with previously undiagnosed CMT1X. Pediatr Blood Cancer. 2009;52(2):298\u2013300."},{"issue":"6","key":"i1551-6776-23-5-417-b11","series-title":"Antimicrob Agents Chemother","first-page":"2806","article-title":"Posaconazole exposure-response relationship: evaluating the utility of therapeutic drug monitoring","volume":"56","year":"2012","unstructured":"Dolton\n              MJ\n            , RayJE, MarriottD, \n          et al. Posaconazole exposure-response relationship: evaluating the utility of therapeutic drug monitoring. Antimicrob Agents Chemother. 2012;56(6):2806\u20132813."},{"issue":"8","key":"i1551-6776-23-5-417-b12","series-title":"JAMA","first-page":"815","article-title":"Association of an inherited genetic variant with vincristine-related peripheral neuropathy in children with acute lymphoblastic leukemia","volume":"313","year":"2015","unstructured":"Diouf\n              B\n            , CrewsKR, LewG, \n          et al. Association of an inherited genetic variant with vincristine-related peripheral neuropathy in children with acute lymphoblastic leukemia. JAMA. 2015;313(8):815\u2013823."},{"issue":"5","key":"i1551-6776-23-5-417-b13","series-title":"Curr Opin Pharmacol","first-page":"491","article-title":"Pharmacodynamic implications for use of antifungal agents","volume":"7","year":"2007","unstructured":"Lewis\n              RE.\n            \n          \n          Pharmacodynamic implications for use of antifungal agents. Curr Opin Pharmacol. 2007;7(5):491\u2013497."}],"container-title":["The Journal of Pediatric Pharmacology and Therapeutics"],"original-title":[],"link":[{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/23\/5\/article-p417.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/meridian.allenpress.com\/jppt\/article-pdf\/23\/5\/417\/1782194\/1551-6776-23_5_417.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/23\/5\/article-p417.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/23\/5\/article-p417.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:35:25Z","timestamp":1747355725000},"score":1,"resource":{"primary":{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/23\/5\/article-p417.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018]]},"references-count":13,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.5863\/1551-6776-23.5.417","relation":{},"ISSN":["1551-6776"],"issn-type":[{"type":"print","value":"1551-6776"}],"subject":[],"published":{"date-parts":[[2018]]}}}